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March 19, 2009

CRSP speaker discusses health effects of discrimination

“Discrimination is a potentially powerful explanation about how race and ethnicity may be linked to health,” said David Takeuchi, associate dean for research at the University of Washington School of Social Work.

Takeuchi shared some of his work on perceptions of discrimination among Latinos and Asian Americans and offered his thoughts on future research trends in his March 16 talk, “Discrimination and Its Health Consequences Across Diverse Racial Groups,” part of the Center on Race and Social Problems spring speaker series.

Takeuchi’s work on the National Latino and Asian American Study, conducted with co-PI Margarita Alegría of the Center for Multicultural Mental Health Research at Cambridge Health Alliance/Harvard Medical School, aimed, in part, to describe how perceptions of discrimination are distributed among Asian Americans and Latinos and how those perceptions are linked to health.

“One ignored and often neglected factor is examining how [discrimination] is related to different racial and ethnic groups other than African Americans,” he said, noting that Latinos and Asian Americans are “two groups you don’t hear much about when you see the literature on discrimination.”

The researchers sampled 2,500 Latinos (Cubans, Mexican Americans, Puerto Ricans and other) and 2,095 Asian Americans (Chinese, Vietnamese, Filipino and other) age 18 and older.

Among the measures Takeuchi studied were subjects’ perceptions of everyday unfair treatment — for instance whether they felt they were treated with less courtesy or less respect; whether they felt they received poor service at restaurants; whether they felt they were perceived as less intelligent, dishonest or someone to be feared, or if they had been threatened, harassed or called names.

For a broader picture, he also studied their perceptions of discrimination — whether they felt they or their friends were treated unfairly because of their ethnicity.

Surprisingly, Takeuchi found that where respondents were born played a significant role in their perceptions.

When asked about whether they felt they had been treated with less courtesy as part of questioning about everyday unfair treatment, 60 percent of Asian immigrants said yes, as did 53 percent of Latino immigrants. But, 75 percent of U.S.-born Asians and 70 percent of U.S.-born Latinos felt that was the case — a difference that was statistically significant, Takeuchi said.

“Nativity was a stronger predictor than ethnicity of our respondents,” he said.

However, although fewer immigrants perceived unfair treatment, “they were more likely to attribute their daily insults to their race or ethnicity,” Takeuchi said, while American-born respondents were more likely to cite other factors such as social or physical circumstances.

In his analysis on health impacts, Takeuchi said there was a “strong and consistent effect.” Both everyday discrimination against an individual and the broader perceived discrimination against their ethnicity had a profound effect on depression for Latinos and Asian Americans, regardless of where they were born.

“While the reports of discrimination may vary, they both show a consistent and strong effect on major depression, a serious mental health problem in this country,” Takeuchi said.

Looking toward future research trends, Takeuchi predicted studies of discrimination would move beyond self-reports and into audits of how discrimination operates in different contexts such as in communities, institutions or health care systems.

He predicted there would be more attempts to document how discrimination may be associated with biological processes. “Does it raise your blood pressure, for example? Does it have an association beyond the self-reports of health included in my study? Does it have a kind of biological response that previously has not been well documented?” he said.

Other directions, Takeuchi said, may focus on the importance of places. “What is it about social contexts that matter in terms of people’s health, mental health and the perceptions of unfair treatment? The notion of geographic space has been an important one in recent years,“ he said, looking toward more studies that document how neighborhoods impact health.

He sees the research trend moving toward examining “not just the physical spaces in which people live, but what it is about the social relationships they have in those spaces.

“Place is more than where you live, it’s also the kinds of connections you have to where you live. It is the history, it is the meaning, it is the social bond you have. In places you can feel connected; you also can feel disconnected. You can feel integrated or you can feel alienated,” he said.

He said he also anticipates research into the theory of limited difference, which has been examined in terms of gender discrimination. The theory suggests “it’s not really big factors you can document,” but rather small differences that accumulate over time to create disparities.

For example, Takeuchi said male and female scientists start out on par in terms of publication, but over time, men outpublish women by at least 2:1.

“What [theorists] suggest is there are these little events in the academic career of a scientist that accumulate to create these big events,” he said. Discrimination has only a small effect. For example, Takeuchi said, women scientists may take a longer period of time to connect with a mentor. “That delay leads to a longer delay in getting the first publication, a longer delay in that first grant and so on. It’s the accumulation of little differences that creates this big gap in the careers of scientists,” he said.

With regard to discrimination, how might a person respond to early instances of unfair treatment? Does it lead to him or her avoiding places or not avoiding places, or other effects? “Looking at this kind of longitudinal, more person-centered kind of analysis, I think, will lead to a better understanding about how discrimination in these discrete events leads to these long-term kinds of effects,” Takeuchi said.

“In looking at health disparities, the explanation of discrimination and health, I think we’ll move more toward examining these kinds of little effects over time that explain these big differences to different racial groups.”

—Kimberly K. Barlow

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